Advocates of so-called medical aid in dying promote a waiting-period safeguard, which they work to jettison once assisted suicide has been made legal.
Advocates of so-called medical aid in dying promote a waiting-period safeguard, which they work to jettison once assisted suicide has been made legal.
O ne could be forgiven for not knowing that assisted-suicide legislation is progressing across the United States. Supporters of assisted suicide mask their effort with euphemism and obfuscation, most notably by denying that a doctor who prescribes life-ending drugs to help patients intentionally end their lives assists suicide. Suicide, it’s often said, is an impulsive act; “medical aid in dying,” on the other hand, is undertaken rationally and only after careful consideration.
Yet the recent trend of reducing or eliminating waiting periods for assisted suicide belies that claim and reveals it as a bait and switch.
In the popular imagination, suicide is an impulsive act: Desperate individuals who feel trapped by their circumstances unthinkingly take their own lives because they see it as the only way out of adverse circumstances. While it can sometimes include planning, many believe the person who commits suicide does so rashly while overwhelmed by stress or suffering acute mental or physical pain.
Assisted-suicide legislation originally insulated “aid in dying” against that kind of impulsivity by mandating waiting periods. Advocates believed they could persuade the public that the practice was different from suicide in part because the law required enough time to prevent careless and impulsive choices. Terminally ill individuals who wanted to end their lives had to make a request, wait at least 15 days, and then make a second request. Waiting periods were sold as a safeguard; individuals could not choose to bring about their deaths on a whim and without sufficient consideration of alternatives.
But now that “aid in dying” is up and running in ten U.S. states, waiting periods are being recklessly abandoned. Oregon, the first state to allow legal access to life-ending drugs, amended its legislation in 2020 to allow individuals to waive the waiting period if the doctor believed that the patient could not survive long enough to ingest the drugs. Other states have been more brazen, simply shortening their waiting periods to seven days (Colorado), five days (Hawaii), or as little as 48 hours (California).
Of the states that mandated at least a 15-day waiting period in their assisted-suicide legislation, that safeguard has either been reduced or limited or could be limited in pending legislation in every state except Maine.
Indeed, legislative efforts are souring on the idea of significant waiting periods altogether. When New Mexico passed its assisted-suicide legislation in 2022, it became the first state to abandon a meaningful waiting period from the start, opting for a trivial 48-hour waiting period that could be waived. Assisted-suicide legislation introduced in 2024 in Iowa and New Hampshire followed New Mexico’s lead. Similar legislation introduced in New York and Minnesota omitted waiting periods entirely. This free fall toward death on demand mirrors the situation in Canada, which in 2021 also abandoned its ten-day waiting period for terminally ill patients.
The trend to eliminate waiting periods is motivated by a push to expand access to assisted suicide. After California shortened its waiting period in 2021 from 15 days to 48 hours, it subsequently saw a 47 percent increase in lethal prescriptions. The waiting period, once seen as a safeguard that would protect patients from rash decision-making, is now seen as a barrier to so-called standard and essential medical care. Waiting periods were once a necessary way of making assisted suicide an option of last resort. Their swift erosion shows how death as a treatment option becomes a simple and immediate solution for terminal patients and their doctors.
The playbook was predictable from a mile away: Insist that patients ingesting fatal drugs isn’t suicide because impulsive decisions are prohibited by law; leave aside the inconvenient truth that suicides are not actually regularly impulsive; then, once “aid in dying” language takes hold in the public consciousness, the alleged difference from suicide can simply be discarded altogether as a matter of denying patients what they need and want.
What is not being asked, however, is how patients are protected by the abandonment of waiting periods for assisted suicide. Why do we need to extend dying patients the option of suicide if their deaths are imminent? And, more important, how can we be sure these decisions are being made with sufficient thoughtfulness, care, and consideration of all options?
Supporters will say that we need to abandon waiting periods at least in certain situations because patients are so sick that they can die before being able to take life-ending drugs. What they don’t explain is why death needs to come by the patient’s so-called choice and the doctor’s assistance. The idea that suicide is chosen to prevent unbearable physical suffering at the end of life is mostly contradicted by the data. Assisted-suicide proponents also neglect to mention that dying patients often experience moments of lucidity and energy, as well as positive deathbed visions, just before they die.
The original instinct for waiting periods was right. If we’re going to make death a treatment option, we’d better be sure that people are not choosing it out of desperation and rashness. If we’re going to introduce intentional killing into professional medicine, we need to give people time before making an irreversible and fatal decision.
The now almost universal abandonment of waiting periods suggests that these reasonable considerations were never part of the motivation to legalize assisted suicide in the first place. Instead, they were temporary measures to sell the public on a controversial and risky policy that could be discarded with less outcry once people become acclimated to it as a medical option.
The erosion of waiting periods is not the only safeguard being abandoned in the push to legalize assisted suicide but is particularly revealing about the progressing culture of death. Assisted suicide is not different and was never expected to be different from other cases of suicide. Advocates now argue, unsurprisingly, that we can’t make people wait for “aid in dying,” an often ill-considered act masquerading as legitimate medical care.